154 articles - From Friday Feb 03 2023 to Friday Feb 10 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline. We recommend that most patients requiring inpatient colonoscopy undergo a nonurgent colonoscopy because performing an urgent colonoscopy within 24 hours of presentation has not been shown to improve important clinical outcomes such as rebleeding. Finally, we provide updated recommendations regarding resumption of antiplatelet and anticoagulant medications after cessation of LGIB. |
| Gastroenterology |
AGA Clinical Practice Update on Diagnosis and Management of Acute Hepatic Porphyrias: Expert Review. BEST PRACTICE ADVICE 11: Patients with AHP on treatment should undergo surveillance for chronic kidney disease annually with serum creatinine and estimated glomerular filtration rate. BEST PRACTICE ADVICE 12: Patients should be counseled on the chronic and long-term complications of AHP, including neuropathy, chronic kidney disease, hypertension, and hepatocellular carcinoma, and need for long-term monitoring. |
| Hepatology |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
| Am J Gastroenterol |
Patients with Crohn's disease and permanent ileostomy are universally excluded from clinical trials: A systematic review. There is an urgent need to identify barriers to enrollment and develop eligibility and outcome measures enabling the inclusion of patients with CD and PI into clinical trials. |
Systematic Review and Meta-Analysis on the Effects of Lactulose and Rifaximin on Patient-Reported Outcomes in Hepatic Encephalopathy. Patients with HE treated with lactulose or rifaximin reported improvements in important PROs. These results may inform provider-patient communication and help manage patient expectations regarding the potential benefits of HE therapies. |
| Clin Gastroenterol Hepatol |
Efficacy of elimination diets in eosinophilic esophagitis: a systematic review and meta-analysis. Dietary therapy is an effective treatment for EoE patients of any age. The current results could support a trend towards less restrictive dietary regimens as a primary treatment option. |
| Gastrointest Endosc |
| Hepatology |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Efficacy of 1-kestose supplementation in patients with mild to moderate ulcerative colitis: A randomised, double-blind, placebo-controlled pilot study. Oral 1-kestose is well tolerated and provides clinical improvement for patients with mild to moderate ulcerative colitis through modulation of the gut microbiome. |
Randomised clinical trial: Psychological intervention improves work productivity and daily activity by reducing abdominal pain and fatigue in Crohn's disease. COBMINDEX is effective at reducing abdominal pain and fatigue in patients with CD, which in turn leads to improvement in functioning. Clinicians should incorporate screening for severe abdominal pain and fatigue and consider offering cognitive-behavioural and mindfulness training. , Number NCT05085925. Ministry of Health in Israel ( |
Randomised clinical trial: Safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan (JP-1366), a novel potassium-competitive acid blocker, in healthy subjects. Zastaprazan was safe and well tolerated after a single oral dose up to 60 mg and multiple oral doses up to 40 mg. It also showed rapid, potent suppression of gastric acid secretion. Pharmacodynamic and pharmacokinetic profile of zastaprazan was suitable for treatment of patients with acid-related diseases. |
| Am J Gastroenterol |
A Prospective Study of Preemptive Tenofovir Disoproxil Fumarate Therapy in HBsAg-Positive Patients With Diffuse Large B-Cell Lymphoma Receiving Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. Preemptive TDF therapy in HBsAg-positive patients with diffuse large B-cell lymphoma receiving R-CHOP chemotherapy was safe and effective for preventing HBV-related hepatitis. However, a long-term maintenance strategy of preemptive TDF therapy should be recommended because of the relatively high rate of HBV-related hepatitis after withdrawal from TDF ( ClinicalTrials.gov ID NCT02354846). |
A Randomized, Double-Blind, Controlled Trial of Percutaneous Tibial Nerve Stimulation With Pelvic Floor Exercises in the Treatment of Childhood Constipation. PTNS with PFE is a safe and effective method in the treatment of childhood constipation, particularly in children with PFD or dyssynergic defecation. |
COVID-19 Vaccine Effectiveness Against the Omicron Variant in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease. The boosted state was associated with a lower risk of SARS-CoV-2 infections and COVID-19-related hospitalization. Efficacy was lower than what has been seen against previous variants and decreased with prolonged duration from the booster. These findings suggest that patients with IBD, especially those who are immunosuppressed, should consider getting a second booster as per Centers for Disease Control and Prevention recommendations. |
Epidemiology and Economic Burden of Acute Infectious Gastroenteritis Among Adults Treated in Outpatient Settings in US Health Systems. AGE is a common and costly disease affecting adults of al ages and more females than males, including individuals with or without baseline conditions in a hospital-based outpatient setting. C. difficile was the most common pathogen detected. |
Evaluating a Novel, Portable, Self-Administrable Device ("Beacon") that Measures Critical Flicker Frequency as a Test for Hepatic Encephalopathy. Beacon can be self-administered by patients with chronic liver disease and cirrhosis to measure CFF, a validated screening test for minimal hepatic encephalopathy. |
Has the Incidence of Inflammatory Bowel Disease Peaked? Evidence From the Population-Based NorDIBD Cohort 1978-2020. Our population-based NorDIBD cohort suggests stabilizing of the incidence of IBD in Denmark, whereas the prevalence continues to rise. Because the data represent a 10% sample of the entire Danish IBD population, we believe that data can be extrapolated to the IBD population in general and used for healthcare planning. |
Incidence of cirrhosis among recent immigrants and refugees to Ontario, Canada. N=25,054 immigrants/refugees were identified with rates of cirrhosis lower compared to Canadian/long-term residents for al etiologies expect HBV likely explained by the health immigrant effect. NAFLD was the most common etiology of cirrhosis among immigrants and refugees. |
Liver Cirrhosis Increases the Risk of Herpes Zoster: A Nationwide Population-based Cohort Study. Patients with LC, particularly those who are not currently recommended for HZ vaccination, were at an increased risk of HZ and HZ-related hospitalization compared to the general Korean population. |
Withdrawal of long-term nucleotide analogue therapy in chronic hepatitis B: Outcomes from the withdrawal phase of the HBRN immune active treatment trial. Results from this trial do not support TDF withdrawal as a therapeutic strategy. HBsAg loss was infrequent within 2 years of stopping long-term TDF. If withdrawal is considered, HBV DNA should be carefully monitored with reinitiation of therapy if levels rise above 4 log10IU/mL to reduce the risk of ALT flares, as they were not associated with subsequent HBsAg decline or loss. |
Working to Answer the Effectiveness of Nutrition in IBD: Still a Ways to Go. These dietary studies are a welcome addition to a poorly understood field of dietary management of IBD, we explore some practical challenges including trial designs, recruitment, and retention in long term dietary intervention studies. Future dietary intervention studies should, therefore, incorporate endoscopic end points to establish a true anti-inflammatory response to elimination diets, preferably with detailed multi-omics analysis to understand mechanism of action. |
| Clin Gastroenterol Hepatol |
Adalimumab in biologic-naïve patients with Crohn's disease after resolution of an intra-abdominal abscess: a prospective study from the GETAID. Provided that the abscess was carefully managed before initiating medical treatment, this study showed the high efficacy of ADA in the short and long term in biologic-naïve patients with CD complicated by an intra-abdominal abscess. |
Diagnostic value of adding magnifying chromoendoscopy to magnifying narrow-band imaging endoscopy for colorectal polyps. In this multicenter prospective study, we demonstrated the additional value of MCE on M-NBI and suggested that additional MCE be recommended for lesions with low confidence or the ones diagnosed as =T1b CRC. |
Saroglitazar, A Dual PPAR a/ Saroglitazar improved the serum atherogenic lipoprotein profile in patients with NAFLD, irrespective of co-morbid conditions and statin use. Saroglitazar has the potential to not only positively affect liver disease but also reduce cardiovascular risk in patients with NAFLD. |
The socioeconomic impact of irritable bowel syndrome: an analysis of direct and indirect healthcare costs. Productivity loss is the main contributor to the socioeconomic burden of IBS. Direct costs were not predominantly related to gastrointestinal care, but rather to mental healthcare. Awareness of the nature of costs and contributing patient factors should lead to significant socioeconomic benefits for society. |
| Endosc Int Open |
Comparing size measurement of colorectal polyps using a novel virtual scale endoscope, endoscopic ruler or forceps: A preclinical randomized trial. VSE had significantly higher relative accuracy in measuring polyps compared to ER or BF assisted measurement. VSE improves correct classification of polyps at clinically important size thresholds. |
Endoscopic ultrasound in patients with resectable perihilar cholangiocarcinoma: impact on clinical decision-making. EUS-TA may be of value in patients with potentially resectable pCCA based on preoperative cross-sectional imaging, regardless of lymphadenopathy at cross-sectional imaging. A prospective study in which a comprehensive EUS investigation with LN assessment and EUS-TA of LNs is performed routinely should confirm this promise. |
ERCP for bile duct stones across a national service, demonstrating a high requirement for repeat procedures. This may have a negative impact on both patient outcomes and experience, and increase pressure on endoscopy services. Apparent variation of outcome between acute hospital care providers requires further analysis. |
| Endoscopy |
Deep-learning-based clinical decision support system for gastric neoplasms in real-time endoscopy: Development and validation study. The CDSS demonstrated potential for real-clinic application and high performance in terms of lesion detection and classification of detected lesions in the stomach. |
Effectiveness and safety of cold snare polypectomy and cold endoscopic mucosal resection for 10-19 mm non-pedunculated colorectal polyps: a multicenter observational cohort study. CSP/C-EMR for morphologically suitable 10-19mm non-pedunculated colonic polyps is effective and safe, including for conventional adenomas. Rates of incomplete resection and recurrence were low, with few adverse events. Studies directly comparing to hot snare resection are required. |
Endoscopic Papillectomy for Ampullary Lesions in patients with Familial Adenomatous Polyposis compared to sporadic lesions in a propensity-score matched cohort. EP is safe and effective in FAP-related ampullary lesions Criteria for endoscopic resection of AL can be extended to FAP-patients. FAP-patients have a life-time risk to relapse even after complete resection and require long-time-surveillance. |
No-touch endoscopic full-thickness resection technique for gastric gastrointestinal stromal tumors. CONCLUSIONS : NT-EFTR was a feasible method for the resection of gastric GISTs and can be expected to achieve complete radical resection. Large tumors with extraluminal growth and large gastric defects impact procedural difficulty. |
Prolonged patency of fully covered self-expandable metal stents with an externally anchored plastic stent in distal malignant biliary obstruction. There were no significant differences in the rates of stent occlusion and adverse events between the two groups. CONCLUSIONS : A novel and simple technique of anchoring an external plastic stent may decrease the risk of FCSEMS migration and prolong stent patency, without significantly increasing the adverse events rate in dMBO. |
| Gastroenterology |
An Evaluation of Critical Factors for the Cost-Effectiveness of Real-Time CAD: Sensitivity and Threshold Analyses Using a Microsimulation Model. As CAD is implemented clinically, it needs to improve mean ADR from 26% to at least 30% or cost less than $579 per-colonoscopy to be cost-effective when compared to traditional colonoscopy. Further studies are needed to understand CAD impact in community practice. |
Global epidemiology and genetics of hepatocellular carcinoma. While there are genetic conditions that confer increased risk for HCC, these diagnoses are rarely recognized outside North America and Europe. In this review, we will evaluate the epidemiological trends and risk factors of HCC, and discuss the genetics of HCC including monogenic diseases, single-nucleotide polymorphisms, gut microbiome, and somatic mutations. |
Hereditary Diffuse Gastric Cancer. We review the pathology of the disease, the mechanism of tumor initiation and its natural history. Finally, we describe current best practice for the clinical management of HDGC including emerging genetic testing criteria for the identification of new families, methods for endoscopic surveillance, the complications associated with prophylactic surgery, post-operative quality of life and the emerging field of HDGC chemoprevention. |
Low Hepatitis B Core-Related Antigen Levels Correlate Higher Spontaneous Seroclearance of HBsAg in Chronic Hepatitis B Patients with High HBsAg Levels. Results There were 465 patients who cleared HBsAg with 32414.72 person-years of follow-up with a mean clearance rate of 1.43% per year. We found that lower HBcrAg levels at baseline were associated with an increased likelihood of HBsAg seroclearance (logrank P 1000 IU/mL, clearing HBcrAg may serve as an early biomarker for HBsAg seroclearance. |
PNPLA3 genotype and diabetes identify patients with non-alcoholic fatty liver disease at high risk of incident cirrhosis. PNPLA3-rs738409 genotype and diabetes identified patients with NAFLD currently considered indeterminate risk (FIB4 1.3-2.67) who had similar risk of cirrhosis as those considered high-risk (FIB4 2.67). PNPLA3 genotyping may improve prognostication and allow for prioritization of intensive intervention. |
Proteome-wide Mendelian randomization identifies causal links between blood proteins and acute pancreatitis. This large GWAS meta-analysis for AP identified new variants linked with AP as well as several blood proteins that may be causally associated with AP. This study provides new information on the genetic architecture of this disease and identified pathways related to AP, which may be further explored as possible therapeutic targets for AP. |
Surveillance in Barrett's Esophagus: Challenges, Progress and Possibilities. Development and implementation of validated quality indicators will allow additional advancement of this critical field. These approaches will hopefully enable efficient and effective cancer prevention and treatment. |
| Gastrointest Endosc |
A Comparison between Traumatic and Atraumatic Over-The-Scope-Clips in patients with Duodenal Ulcer Bleeding: a Retrospective Analysis with Propensity-Score-based Matching. OTSC-a should be the preferred option for duodenal ulcer bleeding if the endoscopist aims for an over-the-scope-clip. |
Automated Electronic Health Record-Based Application for Sedation Triage in Routine Colonoscopy. The EHR-based application, which automates and standardizes determination of sedation type, is a highly beneficial tool that eliminates subjectivity in decision-making, thus allowing for appropriate use of MAC. Complication rates and sedation failure did not increase with use of the application. With the increase in use of MS over MAC, health care costs for the more expensive MAC sedation should also decrease. |
Comparing clinical success and procedural difficulty between treatment-naïve and treatment-refractory patients with esophageal motility disorders during per oral endoscopic myotomy. Prior treatment did not impact POEM clinical success rate and led to decreased case times and easier tunneling difficulty, likely due to persistent LES changes and differences in diagnostic indications. POEM should be considered for patients with treatment-refractory symptoms as a safe and feasible option. Further large scale studies are needed to validate our findings. |
Computer-Aided Diagnosis of Early-Stage Colorectal Cancer Using Non-Magnified Endoscopic White Light Images. CADx developed with endoscopic white light images showed excellent per lesion specificity and accuracy for T1b lesion diagnosis, equivalent to experts and superior to trainees. (UMIN000037053) (249 =<250 words). |
Economic impact of implementing optical diagnosis with a "resect and discard" strategy within the English Bowel Cancer Screening Programme: Findings from the DISCARD3 study. OD with a RD strategy for diminutive and small polyps during BCSP colonoscopy would offer substantial cost savings without adversly affecting surveillance interval concordance. |
Risk of post sphincterotomy bleeding with antiplatelet and anticoagulant use - A propensity-matched analysis of United States Collaborative Network. Our database analysis shows that patients on AC and APT are indeed at a higher risk of post sphincterotomy bleeding, compared to matched controls. Appropriate drug cessation period or alternative biliary decompression modalities may be utilized in these patients. |
Safety and Feasibility of Same-Day Discharge After Endoscopic Submucosal Dissection: A Western Multicenter Prospective Cohort Study. SDD after ESD can be safe and feasible. Invasive cancer, lesions in the upper GI tract, those associated with longer procedure or performed by low ESD volume endoscopists are more likely to be admitted post-procedurally. Risk stratification of patients for SDD after ESD should help optimize resource utilization and enhance ESD uptake in the West. |
Utilization Pattern of Prophylactic Measures for Prevention of Post-ERCP Pancreatitis: A National Survey Study. Physicians with higher annual ERCP volume, teaching hospital based ERCP practices and who regularly perform pancreatic ERCP are more likely to use PPS. Therapeutic ERCP fellowship training and recent entry into practice were also associated with PPS utilization. Indomethacin use appears to be more frequent than PPS. Our findings suggest IND is supplanting PPS as the preferred method of PEP prophylaxis. |
| Gut |
Dose escalation randomised study of efmarodocokin alfa in healthy volunteers and patients with ulcerative colitis. Efmarodocokin alfa had an adequate safety and pharmacokinetic profile in HVs and patients. Biomarker data confirmed IL-22R pathway activation in the colonic epithelium. Results support further investigation of this non-immunosuppressive potential inflammatory bowel disease therapeutic. |
IL-17A-producing CD8+ T cells promote PDAC via induction of inflammatory cancer-associated fibroblasts. We identified Tc17 as a novel protumourigenic CD8 + T-cell subtype in PDAC, which accelerated tumour growth via IL-17RA-dependent stroma modification. We described a crosstalk between three cell types, Tc17, fibroblasts and tumour cells, promoting PDAC progression, which resulted in poor prognosis for patients. |
| Hepatology |
5S rRNA pseudogene transcripts are associated with interferon production and inflammatory responses in alcohol-associated hepatitis. Increased expression and binding availability of RNA5SP transcripts was associated with hepatic IFN production and inflammation in sAH. These data identify RNA5SP transcripts as a potential target to mitigate inflammation and hepatocellular injury in AH. |
Examining the interim proposal for name change to steatotic liver disease in the US population. The current analysis assessed the proposed changes based on discussions from the consensus meeting. Although the definitions are an interim analysis of discussions, steatotic liver disease respects the underlying liver etiology and reduces stigma while increasing awareness of FL among viral and alcohol-associated steatosis/steatohepatitis. |
Liver-restricted deletion of the biliary atresia candidate gene Pkd1l1 causes bile duct dysmorphogenesis and ciliopathy. Bile duct ligation of the Pkd1l1-deficient mouse model mirrors several aspects of the intrahepatic pathophysiology of biliary atresia in humans including bile duct dysmorphogenesis, peribiliary fibroinflammation, hepatic arteriopathy, and ciliopathy. This first genetically linked model of biliary atresia, the Pkd1l1 LKO mouse, may allow researchers a means to develop a deeper understanding of the pathophysiology of this serious and perplexing disorder, including the opportunity to identify rational therapeutic targets. |
Plasma proteomic signature of fatty liver disease: the Rotterdam Study. Among the general population, several inflammatory and cardiometabolic plasma proteins were associated with FLD and fibrosis. Particularly plasma levels of FGF-21, IL-18R1 and CES1 were largely dependent on the presence of FLD and fibrosis, and may therefore be important in their pathogenesis. |
Rngtt governs biliary-derived liver regeneration initiation by transcriptional regulation of mTORC1 and Dnmt1 in zebrafish. Furthermore, rptor and dnmt1 mutants displayed the same liver regeneration defects as rngtt mutation. In conclusion, our results suggest Rngtt is a new factor that initiates BEC-derived liver regeneration. |
| J Hepatol |
A Human Liver Organoid Screening Platform for DILI Risk Prediction. The high throughput and liver-on-chip system exhibit enhanced in vivo-like function and demonstrate the potential utility of these platforms for hepatotoxicity risk assessment. Tenofovir-inarigivr associated hepatotoxicity was observed and correlates with the clinical manifestation of DILI observed in patients. |
Utilization of livers donated after circulatory death for transplantation - An international comparison. We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. Impact and implications A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significantly between 18.9% and 74.2%. For example, the median DCD III liver utilization in five countries, e.g., Belgium, France, Italy, Switzerland, and Spain is 65%, in contrast to 24% in the Netherlands, UK and US. Despite this, and despite different rules and strategies for organ acceptance and preservation, the one and five-year graft survival remains currently relatively comparable among al participating countries. Factors which impact on DCD liver acceptance rates include the national pre-selections of donors, before the offer is made, as well as cutoffs for key risk factors, including donor age and donor warm ischemia time. In addition, a highly varying experience with modern machine perfusion technology is noticed. In situ and ex situ liver perfusion concepts, and assessment tools for type III DCD livers before transplantation may be one key part for the observed differences in better DCD III utilization. |
| Neurogastroenterol Motil |
Efficacy and safety of olorinab, a full agonist of the cannabinoid receptor 2, for the treatment of abdominal pain in patients with irritable bowel syndrome: Results from a phase 2b randomized placebo-controlled trial (CAPTIVATE). Although olorinab was well-tolerated and improved weekly AAPS, the primary endpoint was not met. However, in participants with moderate-to-severe pain at baseline (AAPS =6.5), olorinab 50 mg significantly improved weekly AAPS compared with placebo. NCT04043455. |
Gastrointestinal-Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life. The VSI is an adequate measure of GI-specific anxiety in patients with gastroparesis. Higher GI-specific anxiety was associated with increased patient-reported gastroparesis symptom severity and decreased quality of life, beyond depression/anxiety. |
The effect of combined oral contraceptives and Nexplanon on gastroesophageal reflux disease in premenopausal women: A nationwide database analysis. Combined oral contraceptives is an independent risk factor for GERD, while Nexplanon has a limited protective effect. Further studies are needed to confirm the different effects on GERD of these two contraceptives. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Am J Gastroenterol |
Application of the Latest Advances in Evidence-Based Medicine in Primary Biliary Cholangitis. These include updates to prognostic models on risk stratification, new noninvasive tools for staging of disease, updates to the appropriate use of and long-term treatment results with obeticholic acid as a second-line treatment, the emerging therapeutic role of fibrates, and the advancement of investigational agents for managing PBC. In this updated expert consensus document, we provide updates on staging, the use of noninvasive prognostic tools, and a treatment algorithm to provide evidence-based and practical tools for clinicians who manage PBC, with the ultimate goal to improve the long-term outcomes for patients with this chronic liver disease. |
| Gastroenterology |
| Gut |
Clinical advances: pregnancy in gastroenterologic and hepatic conditions. To be able to provide the best possible care to these patients, gastroenterologists need to be aware of (and familiar with) the various nuances and caveats related to the care of pregnant patients who either have underlying gastrointestinal (GI) conditions or present with GI and liver disorders. Here, we offer a clinical update with references more recent than 2018, along with a few words about SARS-CoV-2 infection and its relevance to pregnancy. |
| J Hepatol |
Advanced endoscopy meets molecular diagnosis of cholangiocarcinoma. This involves a multi-pronged approach incorporating advanced imaging, endoscopic methods, multiple approaches to tissue sampling and molecular markers. We also provide an algorithmic approach for the sequential use of these strategies. |
Healthcare and socioeconomic costs of NAFLD: a global framework to navigate the uncertainties. Lastly, we propose a global NAFLD/NASH investment framework to guide the development of achievable yet ambitious country-specific targets and strategic actions to optimise resource allocation and reduce the prevalence of NAFLD and NASH. Its focus on high-level inputs will be critical to enabling a political and financial environment that supports clinical-level implementation of NAFLD prevention, treatment and care efforts, across al settings. |
Nursing Care For Patients With Cirrhosis. In the primary care setting, nurses should play an important role in the care of patients with compensated cirrhosis and also facilitate early diagnosis of cirrhosis in subjects at risk of liver diseases. This review calls for an improved global liver diseases education program for nurses and increased awareness among al healthcare providers and policy makers of the positive impacts of advanced or specialist nursing practice in this domain. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| J Hepatol |